At the time of his appearance for jury service, or at the time of any interview before the court, Jury Commission, or clerk, any prospective juror may be required or permitted to fill out another juror qualification form in the presence of the court, Jury Commission, or clerk, at which time the prospective juror may be questioned, but only with regard to his questions contained on the form and grounds for his exemption, excuse or disqualification. Any information thus acquired by the court, jury commission, or clerk shall be noted on the juror qualification form.